Nicolas Deniau, Taraneh Shojaei, Alexandre Georges, Jean Danis, Georges Czapiuk, Stephane Mercier, Claudine Maari, Sylvain Pourchet, Elisabeth Balladur, Clement Leclaire
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To assess preliminary impact of this Programme, we conducted a descriptive study on all consecutive patients receiving this intervention during the first year (between 6 September 2021 and 5 September 2022).</p><p><strong>Results: </strong>Among the 352 patients included, main advanced illnesses were cancer (41%), dementia (28%) or chronic organ failure (10%). They were critically ill with acute failures: respiratory (52%), neurological (48%) or circulatory (20%). Main distressing symptoms were breathlessness (43%) and pain (17%). Median response time from call to home-visit (IQR) was 140 (90-265) min. Median length of follow-up (IQR) was 4 (2-7) days. Main outcomes were death at home (72%), improvement (19%) or hospitalisation (9%) including three visits to emergency department (1%).</p><p><strong>Conclusions: </strong>Our study supports that shared decision-making process and urgent care at home are feasible and might prevent undesired hospitalisations.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103340/pdf/","citationCount":"0","resultStr":"{\"title\":\"Home emergency response team for the seriously ill palliative care patient: feasibility and effectiveness.\",\"authors\":\"Nicolas Deniau, Taraneh Shojaei, Alexandre Georges, Jean Danis, Georges Czapiuk, Stephane Mercier, Claudine Maari, Sylvain Pourchet, Elisabeth Balladur, Clement Leclaire\",\"doi\":\"10.1136/spcare-2023-004385\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To characterise trajectories associated with a new team organisation combining critical care and palliative care approaches at home.</p><p><strong>Methods: </strong>We describe the pattern of an emergency response team 24/7 directed to patients with advanced illness presenting a distressing symptom at home, who wanted to stay at home and for whom hospitalisation was considered inappropriate by a shared medical decision-making process in an emergency situation. To assess preliminary impact of this Programme, we conducted a descriptive study on all consecutive patients receiving this intervention during the first year (between 6 September 2021 and 5 September 2022).</p><p><strong>Results: </strong>Among the 352 patients included, main advanced illnesses were cancer (41%), dementia (28%) or chronic organ failure (10%). They were critically ill with acute failures: respiratory (52%), neurological (48%) or circulatory (20%). Main distressing symptoms were breathlessness (43%) and pain (17%). Median response time from call to home-visit (IQR) was 140 (90-265) min. Median length of follow-up (IQR) was 4 (2-7) days. 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Home emergency response team for the seriously ill palliative care patient: feasibility and effectiveness.
Objectives: To characterise trajectories associated with a new team organisation combining critical care and palliative care approaches at home.
Methods: We describe the pattern of an emergency response team 24/7 directed to patients with advanced illness presenting a distressing symptom at home, who wanted to stay at home and for whom hospitalisation was considered inappropriate by a shared medical decision-making process in an emergency situation. To assess preliminary impact of this Programme, we conducted a descriptive study on all consecutive patients receiving this intervention during the first year (between 6 September 2021 and 5 September 2022).
Results: Among the 352 patients included, main advanced illnesses were cancer (41%), dementia (28%) or chronic organ failure (10%). They were critically ill with acute failures: respiratory (52%), neurological (48%) or circulatory (20%). Main distressing symptoms were breathlessness (43%) and pain (17%). Median response time from call to home-visit (IQR) was 140 (90-265) min. Median length of follow-up (IQR) was 4 (2-7) days. Main outcomes were death at home (72%), improvement (19%) or hospitalisation (9%) including three visits to emergency department (1%).
Conclusions: Our study supports that shared decision-making process and urgent care at home are feasible and might prevent undesired hospitalisations.
期刊介绍:
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.